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Track champion reported to have internal male sex organs

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LONDON (AP) - South African runner Caster Semenya's eligibility to compete as a woman is no clearer - even though reports say she has both female and male characteristics.

Semenya, who won the women's 800-meter title at last month's world championship in Berlin, has undergone a gender test, and the results that were given to the IAAF were leaked to Australian newspapers, which claim she has both male and female sex organs.

Former IAAF medical commission chairman Arne Ljungqvist, who would not comment specifically on the Semenya case, cautioned Friday that a person's gender is not always easy to define.

"There is no simple, single lab test that can tell if you are a man or a woman. It is not black and white," Ljungqvist told The Associated Press in a telephone interview from Sweden. "A person who carries a legal certificate showing that he is a man or a women, then they are a man or a woman."

Semenya, who comes from a poor village in rural South Africa, first drew attention when she won the 800 title at the African junior championships. With her muscular build and deep voice, more questions were raised at the world championships.

The International Association of Athletics Federations confirmed that Semenya was undergoing a gender test on the day she won the gold medal in the 800, beating the rest of the field by a huge margin.

Australian newspapers reported that Semenya has no ovaries and has internal testes, which produce testosterone. The IAAF didn't confirm or deny the reports, saying it was reviewing the test results and would announce its findings in November.

Ljungqvist said physical appearance alone does not mean someone is cheating.

"There are many, many other reasons why a woman looks male," Ljungqvist said. "Probably the most common has nothing to do with intersex: production of steroids from the adrenal gland.

"Most of the women you see who look like men are not intersexed. Some men have a very woman-like body shape."

Another key issue is whether an intersexed person can make use of the natural male hormones they may be producing.

"High levels of testosterone is not a relevant parameter. It's whether they can make use of that testosterone," Ljungqvist said. "Most of them are insensitive to the testosterone because they do not have the receptors to use it."

Anne Fausto-Sterling, a professor of biology and women's studies at Brown University, said making use of testosterone to gain a competitive advantage depends on the level of intersexuality.

"Some give no advantage," Fausto-Sterling said. "You really have to know the specifics, and every individual is different."

International Olympic Committee president Jacques Rogge, speaking a day before the Semenya test results were leaked, said the issue surrounding the South African teenager was a difficult one.

"On one hand there are so many different forms of normality in the human body and the human chemistry," said Rogge, who is a retired orthopedic surgeon. "You have all kinds of possibilities there. And it is very difficult to have the unanimous advice of various experts. It's not a clear-cut discussion."

Alice Domurat Dreger, a professor of medical humanities and bioethics at Northwestern University in Chicago, said it was not uncommon for someone to be raised as a woman even if they have both sets of sex organs.

"We are raised based on what adults think our sex is at our births," Dreger said on her Web site. "Various conditions can lead to a baby being born with female genitalia (labia, clitoris, vagina) and internal male sex anatomy (including testes)."

For people with Androgen insensitivity syndrome and 5-alpha reductase Deficiency "the baby has testes inside, even though she's clearly a girl," Dreger wrote.

Gender testing in sports is not new, but it has taken on a new twist. In the old days, it was simply to ensure no one was cheating.

"The gender testing as such is intended to make sure that men do not compete as women," said Ljungqvist, who joined the IAAF medical commission in 1981 and left in 2002 before taking over a similar position with the IOC.

At the 2006 Asian Games, 800 champion Santhi Soundarajan of India was stripped of her medal after failing a gender test. But perhaps the most famous case previous to Semenya is that of Stella Walsh, also known as Stanislawa Walasiewicz, a Polish athlete who won gold in the 100 at the 1932 Olympics, and was later found to have had ambiguous genitalia.

"Such cases are extremely rare in a grown-up population," Ljungqvist said. "Usually intersexed people are diagnosed at birth."

Until the 2000 Sydney Games, the IOC tested all female competitors to make sure no one was cheating, but Ljungqvist fought to change the way that was done.

"Screening was based on the identification of a Y chromosome," Ljungqvist said. "This gender testing by chromosome was completely unscientific and therefore unethical. It took nine more years to get away from it."

Ljungqvist said he finally convinced the IOC to stop the practice ahead of the Sydney Games, but since then they still have people in place in case a question is raised about someone's sexuality.

"At the Olympic Games, since 2000, we always have a panel of experts standing by, comprised by a number of specialists, that can intervene, should we need it," he said.

Copyright 2009 The Associated Press.

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